Thiopurine Methyltransferase (TPMT) and Nudix Hydrolase (NUDT15) Genotyping
| PATIENT INFO |
| Patient Name: |
| Medical Record #: |
| BD: / / Sex: F M |
| PHYSICIAN INFO |
| Physician Name : |
| Address: |
| Ph: ( ) - Fax: ( ) - |
| Additional Report to: |
| Ph: ( ) - Fax: ( ) - |
| TESTS REQUESTED | |
| Test Name: | ICD9 Code: (required) |
| 1. Thiopurine Methyltransferase (TPMT) and Nudix Hydrolase (NUDT15) Genotyping | |
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| SPECIMEN INFO |
| Collection Date & Time: |
| Collected By: |
| Hospital: |
Test ID :
TPNUV
Test Workstation :
MAYO
Specimen Type:
Whole Blood
Tube Type:
Purple top (EDTA) tube: Whole Blood
Collection Volume:
3.0 mL
Minimum Volume:
1.5 mL
Cause for Rejection:
Moderate to Gross Hemolysis, Clotted specimen
Storage:
Refrigerated
Availability:
Sent to reference lab
Methodology:
Liquid Chromatography Tandem Mass Spectrometry (LC-MS/MS)
Special Instructions:
Invert tube several times to mix blood.
Send specimen in original tube.
Test performed Monday through Friday 8am
Lab/Phone:
330-543-8418
TAT:
2-4 days
Additional Info:
Reference range is available on patient report
CPT Code:
80299
Synonyms:
Thiopurine
Purinethol
Mercaptopurine
6MP
6MP
6Thioguanine
Thioguanine
6TGN
6TG
6TGN
6TG
6Methylmercaptopurine
Methylmercaptopurine
6MMP
6MMPN
6MMPN
6MMP
Purine antimetabolites
THIO
TPRBC
Thiopurine Metabolites
6Mercaptopurine
FPMET
